auto vs allo transplant with full sibling match

Musicman · New User Joined: 13 Jun 2008 Posts: 3

I am asked to decide between and auto or an allo transplant with a full sibling match (my sister is a 14/14) by MD Anderson. I am currently taking RICE chemo in preparation for my transplant. I have follicular 3B cancer . Before this I had B-cell marginal zone lymphoma which was treated with R-CHOP. My remission was probably no more than 6 months. What are the odds that the auto would do any good at this point and should I go for the much risky allo in the hopes of getting a decent remission? Opinions please I am so confused. Does anyone here had experience with an allo transplant with a full sibling match?

joepet · Senior User Joined: 18 Dec 2008 Posts: 288 Location: Japan

Hi Musicman. I'm sorry to hear that your battle with the beast has gone into overtime. I have no direct experience, but I will offer my opinions based on what I have heard, with the caveat that I may be wrong.

As you are already aware, there is no easy answer to this question. Generally, the allo offers a better chance at a cure than the auto, but the risks of complications are greater even with a full match. Most doctors that I am aware of usually attempt the auto first, simply because if it doesn't work then they have the option of doing the allo later, whereas if you do the allo first all of your original stem cells would of course be gone.

I suppose the answer could be best determined by your current physical and mental condition. Do you believe that you could endure two stem cell transplants if necessary? If so, then the auto leaves you with more options available for the future, and is less risky in the present. If not, then the allo offers the best chance you have remaining.

If it were me, I would probably do the auto first, giving myself the chance to keep fighting for as long as possible. And you may find that it is not possible to harvest enough of your own stems cells, at which point the decision to do an allo will be automatic, allowing you to be fully at peace with your decision But you have to figure out your own priorities for yourself.

You and your sister will be in my prayers. Good luck!
_________________
Age 37 (36 at diagnosis)
Diffuse Large B cell Lymphoma
Stage 1AE (localized in colon)
Began six cycles of R chop 21 3rd Dec 2008
Finished R chop 21 Apr 2009
Complete remission as of May 2009

Musicman · New User Joined: 13 Jun 2008 Posts: 3

I'm 63 and they will not do Allo transplants over 70. They say my cancer is aggressive and is likely to return more quickly than the average of four years...

I also can't imagine going through this twice. If I was a gambling sort this decision would be easy.

ChemoMan

Hi musicman

The best person to discuss this with is your Doctor. This decision is yours to make and it is not an easy one. learn as much as you can then go back to the doctor with the question.

Whatever you decide I hope the treatment is a success. Don't worry about statistics everyday people make a mockery of them and hopefully you will be one of those people.

Good luck and keep us posted if that is your wish.

Cheers
_________________
Age 52
Diffuse Large B cell Lymphoma
Stage 2a
Finished six cycles of R chop 21 26th May 2008
Officially in remission 9th July 2008
Remission confirmed 1st October 2008
Remission confirmed 17 June 2009
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